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Health visitors urged to check squints are not eye cancer

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A children’s cancer charity is calling for health visitors ensure all new presentations of squints in babies and young children are checked with a red reflex test to rule out eye cancer.

Figures released by the Childhood Eye Cancer Trust show that in 2013, over a quarter of babies and young children diagnosed with retinoblastoma – a rare cancer of the eye – presented with a squint as a symptom.

Retinoblastoma is a fast-growing cancer of the eye affecting mainly children up to the age of five. Around 50 children are diagnosed with it in the UK each year. Early detection is crucial to offer the child the best chance of saving their vision, eyes and life.

“Health visitors have a crucial role in detecting retinoblastoma”

Joy Felgate

As squints are common in babies up to the age of three months, the only way to determine whether it is a sign of cancer is to carry out a simple red reflex test, which simply involves looking in the eye with a hand-held ophthalmoscope.

Charity chief executive Joy Felgate said: “In our experience, some babies and young children are facing serious delays in receiving life-saving treatment as a result of parents either being told incorrectly their baby’s squint is completely normal, or being given a non-urgent squint referral.


Joy Felgate

“Non-urgent squint referrals can take months to come through, which can be a devastating delay for a child with undiagnosed eye cancer,” she warned.

“Health visitors have a crucial role in detecting retinoblastoma,” she added. “We are asking health visitors to support our campaign by ensuring every child’s squint is checked with a red reflex test to rule out retinoblastoma or another serious eye condition.”

The charity has urged health professionals to pay particular attention to children with a recently onset squint, a leukocoria or an abnormal reflex in flash photographs, a change in colour to the iris or deterioration in vision.

Occasionally a retinoblastoma may present as a red, sore or swollen eye without infection. It is important to remember, however, that a child with it may appear systemically well, the charity said.

If it is not too possible to confidently rule out retinoblastoma with a red reflex test, guidelines state an urgent referral must be made, stating “suspected retinoblastoma”.

The charity has developed e-cards and an email campaign that health professionals can share and forward on to colleagues.

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